A skeletal image highlighting shoulder pain.

What is causing my shoulder pain?

Shoulder pain is one of the most common ailments of the human body.  The shoulder is the most mobile joint in the entire body which opens it up to more possibilities for injury.  In addition, our arms are needed in many tasks throughout the day.  The components that make up the shoulder are the glenohumeral joint (ball and socket), scapula (shoulder blade), capsule, rotator cuff, and labrum.  Often times, shoulder problems arise from a deficiency in one or a combination of these components.  The following is a list of common shoulder diagnoses:

  • Rotator Cuff Disorders
  • Labral Disorders
  • Capsular Tightness
  • Scapular Dyskinesis
  • Frozen Shoulder
  • Shoulder Impingement
  • Biceps Tendinopathy
  • Shoulder Instability
Shoulder MRI showing injury.

What is shoulder impingement?

Shoulder impingement can be due to many factors but typically involves pain with elevating the arm.  The pain may either get better or worse as the arm is raised higher.  Check out the video below for a more in depth discussion on shoulder impingement.

How do you know if you have a torn rotator cuff?

The rotator cuff consists of four shoulder muscles (three posterior and one anterior).  The three muscles in the back of the shoulder consist of the supraspinatus, infraspinatus, and teres minor.  These muscles primarily externally rotate and elevate the shoulder.  The muscle in the front of the shoulder is the subscapularis.  Its primary role is to internal rotate the arm.  Rotator cuff injuries may result when lifting a very heavy object in a jerk like fashion.  It can also happen spontaneously after a prolonged period of improper use.

One common question we get from patients is whether or not they tore their rotator cuff.  First off, it must be stated that many individuals have asymptomatic tears of the cuff.  They usually participate in a sport or job that requires frequent usage of the arm.  These tears are usually insignificant and certainly do not require surgery.  On the flip side, a complete rotator cuff tear is a different story.  Called a full thickness tear, this injury usually involves severe pain and the inability to raise the arm at all.

If you are experiencing similar symptoms is does not necessarily mean that your tore your rotator cuff.  Injuries that are more minor in nature, such as tendinitis, can also involve dramatic symptoms.  The above picture demonstrates the shoulder anatomy, most notably the rotator cuff and surrounding structures.

A skeleton with rotator cuff muscles.

What do we do with shoulder pain?

In order for the shoulder to function properly, several components must work in an optimal fashion.  The glenohumeral joint must have proper mobility and be devoid of any injuries.  The scapula, or shoulder blade, must also be mobile but strong and stable as well.  The upper back (thoracic spine) and neck (cervical spine) should not be overly restricted to impede proper movement in the shoulder joint and shoulder blade.

Dr. teaching patient how to strengthen the shoulder.

DNS 4.5 Month Prone Position

The objective when treating shoulder pain is to establish the exact cause.  With a thorough assessment, we can evaluate each component of the shoulder complex.  Chiropractic adjustments help to improve the joint mobility within the upper back and neck region.  Soft tissue manipulation can be used to improve the function within the joint capsule and muscles that influence the shoulder such as the rotator cuff.  Many issues with individuals that experience shoulder pain is that they are weak in the muscles of the shoulder blade.  Functional rehabilitation is imperative to strengthen the shoulder and to improve function so that an individual can go back to their routines pain free.  If you are experiencing shoulder pain or have had shoulder pain in the past, give us a call to schedule a consult to discuss how we utilize a functional approach to get superior results!

What are the best shoulder exercises?

In our opinion, the best shoulder exercises involve the scapula, specifically, the serratus anterior.  This muscle is key to proper scapular stability and is vital in the prevention of shoulder impingement.  Strengthening of the rotator cuff and then loading the shoulder in various positions round out an optimal program for the shoulder.  Below are some exercises that focus on the scapula.